FACTORS ASSOCIATED WITH SILENT ISCHEMIA IN TYPE 2 DIABETIC PATIENTS
DOI:
https://doi.org/10.22159/ajpcr.2024.v17i3.49288Keywords:
Trademill testing, silent myocardial ischaemi, Type 2 Diabetes mellitusAbstract
Objective: The present study was conducted to study the role of treadmill testing (TMT) in identifying silent ischemia in diabetic patients and to assess factors associated with silent ischemia in them.
Methods: The study was a hospital-based cross-sectional study where 60 patients with type 2 diabetes between the age 40 and 60 years without an established clinical diagnosis of coronary artery disease attending medical OPD were included in the study. The TMT was done using a computerized CTMT machine with built-in protocols. Continuous electrocardiogram (ECG) recordings were taken.
Results: The prevalence of silent myocardial ischemia in type 2 asymptomatic diabetes mellitus in this study was found to be 28.3%. Smoking, higher age, alcohol intake, and duration of DM were found to be significantly associated with silent myocardial ischemia.
Conclusion: Thus, we conclude that the prevalence of silent myocardial ischemia is more common in diabetics. Early screening of asymptomatic patients with type 2 diabetes mellitus with the help of TMT for evidence of silent myocardial ischemia may prevent catastrophic cardiac events.
Downloads
References
Kishner S, Miller JP. Electromyography and Nerve Conduction Studies: Background, Indications, Contraindications; 2019. Available from: https://emedicine.medscape.com/article/2094544-overview
Quan D, Khardori R. Diabetic Neuropathy; 2012. Available from: https://img.medscape.com/pi/android/medscapeapp/html/a1170337- business.html
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2010;33:S62-9. doi: 10.2337/dc10-S062, PMID 20042775
Koistinen MJ. Prevalence of asymptomatic myocardial ischaemia in diabetic subjects. BMJ 1990;301:92-5. doi: 10.1136/bmj.301.6743.92, PMID 2390590
Achari V, Thakur AK. Treadmill testing in asymptomatic type 2 diabetes. JAPI 2002;50:50-3.
Hume L, Oakley GD, Boulton AJ, Hardisty C, Ward JD. Asymptomatic myocardial ischemia in diabetes and its relationship to diabetic neuropathy: An exercise electrocardiography study in middle-aged diabetic men. Diabetes Care 1986;9:384-8. doi: 10.2337/ diacare.9.4.384, PMID 3743313
Garg PK, Swaroop AK, Singla S. Silent myocardial ischaemia in type 2 diabetes mellitus. JAPI 2002;50:1471.
Murray DP, O’Brien T, Mulrooney R, O’Sullivan DJ. Autonomic dysfunction and silent myocardial ischaemia on exercise testing in diabetes mellitus. Diabet Med 1990;7:580-4. doi: 10.1111/j.1464- 5491.1990.tb01452.x, PMID 2146063
Gupta SB, Pandit RB. Silent myocardial ischemia and cardiac autonomic neuropathy I diabetes. Ind Heart J 1993;44:227-9.
Ahluwalia G, Jain P, Chugh SK, Wasir HS, Kaul U. Silent myocardial ischemia in diabetics with normal autonomic function. Int J Cardiol 1995;48:147-53. doi: 10.1016/0167-5273(94)02233-9, PMID 7774993
Sukhija R, Dhanwal D, Gambhir DS, Dewan R. Silent myocardial ischaemia in patients with type II diabetes mellitus and its relation with autonomic dysfunction. Indian Heart J 2000;52:540-6. PMID 11256776
Kuusisto J, Lempiäinen P, Mykkänen L, Laakso M. Insulin resistance syndrome predicts coronary heart disease events in elderly type 2 diabetic men. Diabetes Care 2001;24:1629-33. doi: 10.2337/ diacare.24.9.1629, PMID 11522711
Suastika K, Dwipayana P, Siswadi M, Tuty RA. Age is an important risk factor for type 2 diabetes mellitus and cardiovascular diseases. In: Glucose Tolerance. Croatia: InTech; 2012.
Oki GC, Pavin EJ, Coelho OR, Parisi MC, Almeida RC, Etchebehere E, et al. Myocardial perfusion scintigraphy in the detection of silent ischemia in asymptomatic diabetic patients. Radiol Bras 2013;46:7-14. doi: 10.1590/S0100-39842013000100007
Turner RC, Millns H, Neil HA, Stratton IM, Manley SE, Matthews DR, et al. Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom prospective diabetes study (UKPDS: 23). BMJ 1998;316:823-8. doi: 10.1136/bmj.316.7134.823, PMID 9549452
Kothari V, Stevens RJ, Adler AI, Stratton IM, Manley SE, Neil HA, et al. UKPDS 60: Risk of stroke in type 2 diabetes estimated by the UK prospective diabetes study risk engine. Stroke 2002;33:1776-81. doi: 10.1161/01.str.0000020091.07144.c7, PMID 12105351
Morrish NJ, Stevens LK, Fuller JH, Jarrett RJ, Keen H. Risk factors for macrovascular disease in diabetes mellitus: The London follow-up to the WHO multinational study of vascular disease in diabetics. Diabetologia 1991;34:590-4. doi: 10.1007/BF00400279, PMID 1936663
Sakuta H, Suzuki T, Katayama Y, Yasuda H, Ito T. Heavy alcohol intake, homocysteine and type 2 diabetes. Diabet Med 2005;22:1359- 63. doi: 10.1111/j.1464-5491.2005.01653.x, PMID 16176197
Polsky S, Akturk HK. Alcohol consumption, diabetes risk, and cardiovascular disease within diabetes. Curr Diab Rep 2017;17:136. doi: 10.1007/s11892-017-0950-8, PMID 29103170
Published
How to Cite
Issue
Section
Copyright (c) 2023 Abhishek Vashisth, Sanjana Sharma, Ravikumar N Patel, PIYUSH KUMAR GUPTA
This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.
